Survey comparing the treatment of central retinal artery occlusion with hyperbaric oxygen in Australia and New Zealand with the recommended guidelines as outlined by the Undersea and Hyperbaric Medical Society.

Abstract

Introduction: Central retinal artery occlusion (CRAO) presents suddenly causing painless loss of vision that is often significant. Meaningful improvement in vision occurs in only 8% of patients with spontaneous reperfusion. Hyperbaric oxygen treatment (HBOT) is considered to be of benefit if commenced before retinal infarction occurs. The Undersea and Hyperbaric Medical Society (UHMS) guidelines on the management of CRAO were last amended in 2019. This survey questioned Australian and New Zealand (ANZ) hyperbaric medicine units (HMUs) about the incidence of CRAO cases referred and compared their subsequent management against the UHMS guidelines.

Methods: An anonymous survey via SurveyMonkey® was sent to all 12 ANZ HMUs that treat emergency indications, allowing for multiple choice and free text answers regarding their management of CRAO.

Results: One-hundred and forty-six cases of CRAO were treated in ANZ HMUs over the last five years. Most (101/146) cases (69%) were initially treated at a pressure of 284 kPa. This was the area of greatest difference noted in CRAO management between the UHMS guidelines and ANZ practice.

Conclusions: Few ANZ HMUs strictly followed the UHMS guidelines. We suggest a more simplified management protocol as used by the majority of ANZ HMUs.